title: Developing and evaluating interventions to reduce inappropriate prescribing by general practitioners of antibiotics for upper respiratory tract infections: a randomised controlled trial to compare paper-based and web-based modelling experiments.
abstract: BACKGROUND
  Much implementation research is focused on full-scale trials with little evidence of preceding modelling work. The Medical Research Council Framework for developing and evaluating complex interventions has argued for more and better theoretical and exploratory work prior to a trial as a means of improving intervention development. Intervention modelling experiments (IMEs) are a way of exploring and refining an intervention before moving to a full-scale trial. They do this by delivering key elements of the intervention in a simulation that approximates clinical practice by, for example, presenting general practitioners (GPs) with a clinical scenario about making a treatment decision.
  
  
  METHODS
  The current proposal will run a full, web-based IME involving 250 GPs that will advance the methodology of IMEs by directly comparing results with an earlier paper-based IME. Moreover, the web-based IME will evaluate an intervention that can be put into a full-scale trial that aims to reduce antibiotic prescribing for upper respiratory tract infections in primary care. The study will also include a trial of email versus postal invitations to participate.
  
  
  CONCLUSIONS
  More effective behaviour change interventions are needed and this study will develop one such intervention and a system to model and test future interventions. This system will be applicable to any situation in the National Health Service where behaviour needs to be modified, including interventions aimed directly at the public.
  
  
  BACKGROUND
  ClinicalTrials (NCT): NCT01206738.
authors.affiliation: Quality, Safety and Informatics Research Group, University of Dundee, Kirsty Semple Way, Dundee, UK. streweek@mac.com
authors.forename: Shaun
authors.initials: S
authors.lastname: Treweek
authors.forename: Ian W
authors.initials: IW
authors.lastname: Ricketts
authors.forename: Jillian
authors.initials: J
authors.lastname: Francis
authors.forename: Martin
authors.initials: M
authors.lastname: Eccles
authors.forename: Debbie
authors.initials: D
authors.lastname: Bonetti
authors.forename: Nigel B
authors.initials: NB
authors.lastname: Pitts
authors.forename: Graeme
authors.initials: G
authors.lastname: Maclennan
authors.forename: Frank
authors.initials: F
authors.lastname: Sullivan
authors.forename: Claire
authors.initials: C
authors.lastname: Jones
authors.forename: Mark
authors.initials: M
authors.lastname: Weal
authors.forename: Karen
authors.initials: K
authors.lastname: Barnett
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D058005:General Practitioners / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control*; D020407:Internet; D008962:Models, Theoretical; D018579:Patient Selection; D015397:Program Evaluation; D012107:Research Design; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D018401:Sample Size
chemical_list: D000900:Anti-Bacterial Agents